High Anxiety Symptoms Prevalent in Epilepsy, Mesial Temporal Sclerosis

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Approximately a third of patients who reported high levels of anxiety also had high levels of depression.
Approximately a third of patients who reported high levels of anxiety also had high levels of depression.

High anxiety symptoms are independently associated with epilepsy as well as focal/unknown epilepsy and mesial temporal sclerosis, according to study results published in Epilepsy & Behavior.

In a cross-sectional analysis of a retrospective study, investigators analyzed the prevalence of anxiety symptoms in 540 adults with epilepsy. The Symptom Checklist 90-R (SCL-90R) anxiety subscale was used to measure anxiety and depression symptoms in this population; an SCL-90R anxiety T-score of ≥60 was used to define high anxiety. In addition, study researchers collected data on patient demographics and epilepsy localization.

Approximately half (46.1%) of study participants had high anxiety symptoms at the time of study enrollment. There was an independent association between high anxiety with focal or unknown epilepsy type (adjusted odds ratios [OR] 2.89; 95% CI, 1.33-6.29; P =.007) and depression scores per 5-point increase in depression subscale (OR 2.12; 95% CI, 1.83-2.45; P =.001).

In addition, there was an independent association between mesial temporal sclerosis and high anxiety (adjusted OR 2.12; 95% CI 1.11-4.04; P =.023).

In the simple regression model, patient-related factors associated with high anxiety included lower education, Spanish as a native language, prior head trauma, non-white race/ethnicity, anti-seizure drug polytherapy, and left focus or bilateral foci in focal epilepsy.

Of the entire study population, 55% (n=297) had SCL-90R depression T scores ≥60.  In addition, 204 patients reported both high anxiety and depression.

The self-reported symptom checklist and lack of a validated psychiatric interview, as well as the retrospective nature of the data, represent potential limits of the study findings.

Considering many patients with epilepsy with high anxiety do not appear to report highly prevalent depressive symptoms, the investigators suggested regular “screening for both anxiety and depression is important in the epilepsy clinic, particularly among those who do not have generalized epilepsy.”

Reference

Munger Clary HM, Snively BM, Hamberger MJ. Anxiety is common and independently associated with clinical features of epilepsy. Epilepsy Behav. 2018;85:64-71.

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